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E Carmel, J H Curotta, A T Cheng
OBJECTIVE: To evaluate the effect of pre- and post-admission antibiotic treatment in paediatric acute mastoiditis. DESIGN: Retrospective study. METHOD: Eighty-eight children with acute mastoiditis, from 2003 to 2012, were studied to investigate the effect of antibiotic therapy on short and long-term sequelae. RESULTS: The median period of antibiotic therapy immediately following hospital discharge was 10 days (range, 5-49 days; standard deviation = 7...
October 17, 2016: Journal of Laryngology and Otology
Oscar Wambuguh, Monika Eckfield, Lynn Van Hofwegen
Baccalaureate nursing programs select students likely to graduate, become licensed, and contribute to a diverse workforce, and admissions criteria need to support those goals. This study assessed five criteria: pre-admit science GPA; TEAS score; healthcare experience; previous baccalaureate degree; and pre-admission university enrollment vs. college transfer as predictors of three desired outcomes: graduation; nursing program GPA; and passing NCLEX-RN. Results found TEAS and pre-admit science GPA predicted nursing program outcomes...
September 20, 2016: International Journal of Nursing Education Scholarship
Esther Kwong, Nick Black
OBJECTIVE: The unpredictability of the occurrence of illnesses and injuries leading to most emergency admissions to hospital makes it impossible prospectively to collect pre-admission patient reported outcome measures (PROMs). Our aims were to review the evidence for using retrospective PROMs to determine pre-event health status and the validity of using general population norms instead of retrospective PROMs. STUDY DESIGN AND SETTING: Searches of Medline, PsycINFO, Embase, Global Health, and Health Management information...
September 10, 2016: Journal of Clinical Epidemiology
Brenda Ohta, Ana Mola, Peri Rosenfeld, Shauna Ford
BACKGROUND/METHODS: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan...
2016: International Journal of Integrated Care
N A Smith, Y Y Yeow
Postoperative cognitive disorders are common in elderly patients. Pre-existing cognitive impairment including mild cognitive impairment may be an important risk factor for developing postoperative cognitive dysfunction and may not be detected in a standard preoperative interview, yet is not routinely sought. Our primary aim was to estimate the prevalence of mild cognitive impairment among elderly patients presenting to our hospital for elective surgery using a simple established screening tool: the Montreal Cognitive Assessment test...
September 2016: Anaesthesia and Intensive Care
Roman Romero-Ortuno, Stephen Wallis, Richard Biram, Victoria Keevil
AIM: Frail individuals may be at higher risk of death from a given acute illness severity (AIS), but this relationship has not been studied in an English National Health Service (NHS) acute hospital setting. METHODS: This was a retrospective observational study in a large university NHS hospital in England. We analyzed all first non-elective inpatient episodes of people aged ≥75years (all specialties) between October 2014 and October 2015. Pre-admission frailty was assessed with the Clinical Frailty Scale (CFS) of the Canadian Study on Health & Aging, and AIS in the Emergency Department was measured with a Modified Early Warning Score (ED-MEWS<4 was considered as low acuity, and ED-MEWS≥4 as high acuity)...
September 2, 2016: European Journal of Internal Medicine
Paola Forti, Fabiola Maioli, Michele Domenico Spampinato, Carlotta Barbara, Valeria Nativio, Maura Coveri, Marco Zoli, Luigi Simonetti, Giuseppe Di Pasquale, Gaetano Procaccianti
BACKGROUND: Incidence of acute intracerebral hemorrhage (ICH) increases with age, but there is a lack of information about ICH characteristics in the oldest-old (age ≥85 years). In particular, there is a need for information about hematoma volume, which is included in most clinical scales for prediction of mortality in ICH patients. Many of these scales also assume that, independent of ICH characteristics, the oldest-old have a higher mortality than younger elderly patients (age 65-74 years)...
September 6, 2016: Cerebrovascular Diseases
Blanca Rodríguez Vargas, Eva Delgado Silveira, Irene Iglesias Peinado, Teresa Bermejo Vicedo
Background Care transitions are risk points for medication discrepancies, especially in the elderly. Objective This study was undertaken to assess prevalence and describe medication reconciliation errors during admission in elderly patients and to analyze associated risk factors. We also evaluate the effect of these errors on the length of hospital stay. Setting General surgery, orthopedics, internal medicines and infectious diseases departments of a 1070-bed Spanish teaching hospital. Method This is a prospective observational study...
October 2016: International Journal of Clinical Pharmacy
Elena Salmoirago-Blotcher, Lindsey Rosman, Ilan S Wittstein, Shira Dunsiger, Heather H Swales, Gerard P Aurigemma, Ira S Ockene
BACKGROUND: The role of psychological factors in the onset of takotsubo cardiomyopathy (TC) is still controversial. Associations with previous psychiatric conditions are registry-based; associations with personality characteristics and psychological sequelae of TC have been largely unexplored. This case-control study sought to study pre-admission psychiatric morbidity, personality traits, and post-discharge distress in incident cases of TC. METHODS: TC cases (Mayo clinic criteria) and acute myocardial infarction (MI) controls were recruited among women admitted to two Emergency Departments in New England...
August 20, 2016: Heart & Lung: the Journal of Critical Care
Mohamud Egal, Hilde R H de Geus, A B Johan Groeneveld
BACKGROUND: Oliguria occurs frequently in critically ill patients, challenging clinicians to distinguish functional adaptation from serum-creatinine-defined acute kidney injury (AKIsCr). We investigated neutrophil gelatinase-associated lipocalin (NGAL)'s ability to differentiate between these 2 conditions. METHODS: This is a post-hoc analysis of a prospective cohort of adult critically ill patients. Patients without oliguria within the first 6 h of admission were excluded...
2016: Nephron
Puneeta Tandon, Matthew T James, Juan G Abraldes, Constantine J Karvellas, Feng Ye, Neesh Pannu
BACKGROUND: The implementation of new serum creatinine (SCr)-based criteria for acute kidney injury (AKI) has brought to light several areas of uncertainty in patients with cirrhosis. STUDY DESIGN: Population-based cohort study. SETTING & PARTICIPANTS: Adults with cirrhosis hospitalized between 2002-2012. PREDICTOR: We aimed to address the prognostic implications of the new AKI criteria in cirrhosis. OUTCOMES: Baseline kidney function was defined from all outpatient SCr within 3 months before hospitalization...
2016: PloS One
Ciara O' Riordan, Tim Delaney, Tamasine Grimes
Background Discharge prescribing error is common. Little is known about whether it persists post-discharge. Objective To explore the relationship between discharge prescribing error and post-discharge medication error. Setting This was a prospective observational study (March-May 2013) at an adult academic hospital in Ireland. Method Patients using three or more chronic medications pre-admission, with a clinical pharmacist documented gold-standard pre-admission medication list, having a chronic medication stopped or started in hospital and discharged to home were included...
October 2016: International Journal of Clinical Pharmacy
Melissa H Lee, Lillianne Liprino, Jeffrey Brooks, Brenda Cayzer, Fiona Weedon, Kate Bermingham, Alicia J Jenkins, Kevin Rowley, David N O'Neal
The aim was to examine predictors of duration of inpatient hospital stay in people with diabetes mellitus to assist implementation of strategies to reduce hospital stay. This audit prospectively studied patients with diabetes mellitus admitted to a medical unit of an Australian community public hospital. Other outcome measures included glucose treatment optimisation and access to GP and diabetes-specific healthcare professionals. Comparison was made to patients without diabetes mellitus who were admitted concomitantly...
July 28, 2016: Australian Journal of Primary Health
Adrian A Maung, Bishwajit Bhattacharya, Kevin M Schuster, Kimberly A Davis
BACKGROUND: Although anticoagulation with warfarin has been associated with increased risk of adverse outcomes after trauma, the effects of the new oral agents (NOA) such as dabigatran, apixaban, rivaroxaban are not yet well characterized. METHODS: A retrospective review of a level 1 trauma center database identified all patients aged ≥ 50 admitted after trauma during a 24 month period starting September 2013. Demographics, including preadmission anticoagulation agents, injuries, hospital course and outcomes were abstracted from the electronic medical record...
October 2016: Journal of Trauma and Acute Care Surgery
Daniel J Rubin, Elizabeth A Handorf, Sherita Hill Golden, Deborah B Nelson, Marie E McDonnell, Huaqing Zhao
OBJECTIVE: To develop and validate a tool to predict the risk of all-cause readmission within 30 days (30d readmission) among hospitalized patients with diabetes. METHODS: A cohort of 44,203 discharges was retrospectively selected from the electronic records of adult patients with diabetes hospitalized at an urban academic medical center. Discharges of 60% of the patients (n=26,402) were randomly selected as a training sample to develop the index. The remaining 40% (n=17,801) were selected as a validation sample...
July 13, 2016: Endocrine Practice
Caragh Brosnan, Erica Southgate, Sue Outram, Heidi Lempp, Sarah Wright, Troy Saxby, Gillian Harris, Anna Bennett, Brian Kelly
CONTEXT: Students from backgrounds of low socio-economic status (SES) or who are first in family to attend university (FiF) are under-represented in medicine. Research has focused on these students' pre-admission perceptions of medicine, rather than on their lived experience as medical students. Such research is necessary to monitor and understand the potential perpetuation of disadvantage within medical schools. OBJECTIVES: This study drew on the theory of Bourdieu to explore FiF students' experiences at one Australian medical school, aiming to identify any barriers faced and inform strategies for equity...
August 2016: Medical Education
Katarzyna Krenke, Marta Krawiec, Grażyna Kraj, Joanna Peradzynska, Agnieszka Krauze, Marek Kulus
AIM: The aim of this study was to evaluate the factors that could predict the development of local complications (parapneumonic effusion/pleural empyema, necrotizing pneumonia, and lung abscess) in children with community-acquired pneumonia (CAP). METHODS: Demographic, clinical, and laboratory data were prospectively collected and compared in children with noncomplicated and complicated CAP. RESULTS: Two-hundred and three patients aged from 2 months to 17 years were enrolled...
July 12, 2016: Clinical Respiratory Journal
Haijie Liang, Dasen Li, Wei Guo, Rongli Yang, Xiaodong Tang
PURPOSE: To investigate the incidence and risk factors of neuralgia after limb-salvage surgery for pelvic tumors with focus on the reconstruction methods. METHODS: We included 349 cases of pelvic tumors treated with internal hemipelvectomy and reconstruction in our center from January 2009 to May 2015. None of these cases had major lumbosacral nerves invaded by the tumors. Demographic and medical data were reviewed and documented for statistical analyses. The locations of lateral lumbar vertebral body screws (LLVBSs) were evaluated in 26 cases...
July 6, 2016: European Spine Journal
Chalee Engelhard, Rebecca Leugers, Jenna Stephan
The study aimed at finding the value of letters of recommendation in predicting professional behavior problems in the clinical portion of a Doctor of Physical Therapy program learning cohorts from 2009-2014 in the United States. De-identified records of 137 Doctor of Physical Therapy graduates were examined by the descriptive statistics and comparison analysis. Thirty letters of recommendation were investigated based on grounded theory from 10 student applications with 5 randomly selected students of interest and 5 non-students of interest...
2016: Journal of Educational Evaluation for Health Professions
Alana M Flexman, Raphaële Charest-Morin, Liam Stobart, John Street, Christopher J Ryerson
BACKGROUND CONTEXT: Frailty is defined as a state of decreased reserve and susceptibility to stressors. The relationship between frailty and postoperative outcomes after degenerative spine surgery has not been studied. PURPOSE: 1) Determine prevalence of frailty in the degenerative spine population; 2) Describe patient characteristics associated with frailty; 3) Determine the association between frailty and postoperative complications, mortality, length of stay and discharge disposition...
June 30, 2016: Spine Journal: Official Journal of the North American Spine Society
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